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DocuSign Envelope ID:6BDD2794-5EC0-4DFF-B4F6-F496A1C3AB13 <br /> ORANGE COUNTY—DEPARTMENT USE ONLY <br /> Department <br /> Party/Vendor Name: El Centro Hispano, Inc. Party/Vendor Contact Person: Pilar Rocha-Goldberg Contact Phone: <br /> 919-687-4635, x43 Party/Vendor Address: 2000 Chapel Hill Road, Suite 26A City Durham State: NC Zip: 27707 <br /> Department: Finance & Administrative Services Amount: 28810 Purpose: Outside Agencies Funding Budget <br /> Code(s): 10495050-719058 Vendor# 801399 (N/A if new vendor) Vendor is a BOCC consultant? Yes ❑ No❑ <br /> Contract Type: (Check one)New® Renewal❑ Amendment ❑ Effective Date 7/1/16 Approved by Board Yes <br /> ®Nor-1 Agenda Date: 6/21/16 <br /> This agreement is approved as to technical fo andwll lv:by: <br /> Department Director's Signature 481A(-.C142olL Date: <br /> Information Technolo0es <br /> (Applicable only to hardware/software purchases or related services)This agreement has been reviewed and is <br /> approved as to information technology content and specifications: <br /> Office of the Chief Information Officer Date: <br /> Risk Management <br /> This agreement is approved for sufficiency of insuran � lsd§pecifications,and requirements: <br /> ca�Sa COV'ln,t,{fb <br /> Office of the Risk Management Officer Date: <br /> Financial Services <br /> This instrument has been pre-audited in the manner r quiQ@ 'IVYLocal Government Budget and Fiscal Control Act: <br /> Office of the Chief Financial Officer rmn Date: <br /> naFS�g�nrr�anq <br /> Legal Services <br /> This agreement is approved as to legal form and su @R�0?!9nea by: <br /> Office of the County Attorney` Date: <br /> Clerk to the Board <br /> Received for record retention: <br /> All Docusign contracts must be copied to Donna Lloyd upon completion @ Dolloydkorangecount.nic.gov <br /> The following signature block is for hard copies only and is not required for Docusign contracts: <br /> Office of the Clerk to the Board Date: <br /> (El Centro Hispano,Inc) <br /> Orange County Outside Agency Performance Agreement <br /> Rev. 8116 <br />